Proposed Vetting Process Plan

1
Whats New at the Public Health Accreditation
Board?
Kaye Bender, PhD, RN, FAAN MLC Grantee Meeting
Charlotte, NC March 19, 2009
2
Presentation Overview

• Description of PHABs Current Work
• PHAB Board of Directors Strategic Plan
• Program Development and Timeline
• Introduction to the Standards

3
A Rising Tide

• CDCs Future Initiatives
• Future of the Publics Health in the 21st
  Century (IOM)
• Statewide Accreditation Programs
• Exploring Accreditation

4
Accreditation Fits in 2008

• Accreditation, as envisioned by the Public Health
  Accreditation Board, is in tune with heightened
  national movement
• The Healthiest Nation
• Trust for Americas Health Blueprint for a
  Healthier America

5
Commitment of the PHAB Board of Directors and
Staff

• Create demand and successfully deliver PHAB
  accreditation
• Develop and establish PHAB accreditation
• Market and manage the PHAB brand
• Promote strategic partnerships
• Establish sufficient funding
• Strengthen PHAB organizational effectiveness

6
Robert Wood Johnson Foundation Goal

• 60 of the population will be covered by
  accredited health departments by 2015.

7
Credentialing and Accreditation

• Credentialing is a concept that applies to
  individuals who seek public health certification.
• Accreditation is a concept of validating
  performance improvement that applies to state,
  local, tribal, and territorial health
  departments.

8
Voluntary Accreditation Goal

• The goal of a voluntary national accreditation
  program is to improve and protect the health of
  the public by advancing the quality and
  performance of state, local, territorial and
  tribal public health departments.

9
Public Health Accreditation Board

• Established May 2007 in Alexandria, VA
• Governed by state, tribal and local public health
  officials and board of health members
• Health department involvement
• Board of Directors representation
• Workgroups oversee development
• Volunteer opportunities

10
Executive Committee

• Chair Paul K. Halverson
• Vice Chair unfilled
• Secretary/Treasurer Ed Harrison
• Immediate Past President Marie Fallon

11
PHAB Board of Directors

• Kenneth Kerik (OH)
• Carol Moehrle (ID)
• Judy Monroe (IN)
• Bud Nicola (WA)
• Alonzo Plough (CA)
• William Riley (MN)
• F. Douglas Scutchfield (KY)
• H. Sally Smith (AK)

• Kaye Bender, President and CEO
• Rex Archer (MO)
• Shepard Cohen (MA)
• Leah Devlin (NC)
• Marie Fallon (OH)
• Fernando A. Guerra TX)
• Paul K. Halverson (AR)
• Edward Harrison (IL)

12
Funding Partners
13
Eligible Applicants

• All variations of state, local, tribal and
  territorial health departments can apply for
  national accreditation

14
Developmental Work

• Standards Workgroup
• Assessment Process Workgroup
• Beta test
• Equivalency Recognition Workgroup
• Research and Evaluation Committee
• Fees Incentives Workgroup
• Marketing and Communication

15
PHAB Timeline
2007 2007 2007 2007 2008 2008 2008 2008 2009 2009 2009 2009 2010 2010 2010 2010 2011 2011 2011 2011
1 2 3 4 1 2 3 4 1 2 3 4 1 2 3 4 1 2 3 4

Internal Operations
Standards and Measures
Assessment Process
18 Month Beta Test
Applications
16
Standards Development Workgroup

• Workgroup comprises state and local health
  department leaders and BOH members
• Collaborative, consensus, iterative process
• Facilitated by consultant with standards
  development expertise
• MCPP Healthcare Consulting, Inc

17
Standards Development Workgroup

• Leah Devlin (NC) Co-Chair
• Carol Moehrle (ID) Co-Chair
• Terry Allan (OH)
• Rex Archer (MO)
• Tim Callahan (CT)
• Rick Danko (TX)
• Robert Fulton (MN)
• John Gwinn (OH)
• Mary Kushion (MI)
• Richard Morrissey( KS)
• Rita Parris (NE)

• Sylvia Pirani (NY)
• Joy Reed (NC)
• Stephen Ronck (OK)
• Jane Smilie (MT)
• Torney Smith (WA)
• Bonita Sorenson (CA)
• Jeffrey Stoll (CO)
• Susan Turner (FL)
• Harvey Wallace (MI)
• Christina Welter (IL)
• Kathy Vincent (AL)
• Barbara Worgess (AZ)

18
Standards and Measures Development

• Develop standards for all health departments
• Measures specific to local and state health
  departments
• Guidance for documentation and demonstration of
  department performance on meeting standards and
  measures
• Scoring and weighting methodology

19
Standards and Measures Principles

• Advance the collective practice
• Be simple, reduce redundancy
• Minimize burden
• Reinforce local and state health departments
  roles, demonstrate shared accountability
• Apply to all sizes and all forms of governance
  structure
• Based on American National Standards Institute
  principles

20
Principles continued

• Based on a body of existing work
• Essential PH Services
• NACCHO Operational Definition
• National Public Health Performance Standards
  Program
• State Experiences
• ASTHO Survey Data
• Essentially all of the concepts in the
  Operational Definition and NPHPSP have been
  addressed

21
Standards Development Timeline

• Draft standards and measures developed by
  workgroups
• Alpha test/desk review
• Public vetting
• Revised based on feedback
• PHAB Board approval
• Beta testing

• Feb 08-Feb 09
• Oct 08-Nov 08
• Feb 09-April 09
• May 09-June 09
• July 09
• Late summer 09-Nov 10

22
Standards Vetting

• Why?
• Improve standards and measures
• What?
• Standards, measures and documentation guidance
• How?
• Through a variety of online and in-person
  opportunities
• When?
• February-April 2009
• We need to hear from YOU!
• And, we will, in just a few moments!

23
Equivalency Recognition Workgroup

• Bud Nicola (WA) Chair
• Rex Archer (MO)
• Janet Canavese (MO)
• Shepard Cohen (MA)
• Kathleen MacVarish (MA)
• Joan Brewster (WA)
• Pamela Butler (OH)

• Martha Gelhaus (IA)
• Joe Kyle (SC)
• Edd Rhoades (OK)
• Rachel Stevens (NC)
• Debra Tews (MI)
• Lee Thielen (CO)

24
Equivalency Recognition Work Group

• To acknowledge states with existing programs that
  advised the national process
• Not a grandfathering process
• Recognize programs that conform to the national
  program
• Not PHAB accreditation, but eligible for same
  benefits

25
Equivalency Workgroup Products

• Definition
• Guiding Principles
• Eligibility Criteria
• Recognition Criteria

• Application Process (and Fees)
• PHAB SER Review Process
• Scoring Methodology
• Glossary

26
Accreditation System

• A public health accreditation system is a
  network of public health agency accrediting
  bodies, led by PHAB and including state-based and
  regional accrediting programs that work together
  to improve the infrastructure of public health in
  the nation. This will be accomplished through
  PHAB leadership, a commitment to collaboration,
  innovation at the state and national levels, and
  by sharing common goals and objectives.

27
More Recent Work on State-Based Accreditation

• Think Tank to further the discussion
• More work to come..

28
Assessment Process Workgroup

• Determine how to evaluate whether a health
  department has achieved accreditation status
• Determine how health departments can appeal
  decisions
• Professional Accreditation Consultant
• Michael Hamm and Associates

29
Assessment Process Workgroup

• Bud Nicola (WA) Chair
• Christine Abarca (FL)
• Joan Ascheim (NH)
• Janet Canavese (MO)
• Alan Kalos (KY)
• Jerald King (IN)

• Laura Rasar King (DC)
• Richard Matheny (CT)
• Bruce Pomer (CA)
• Rita Schmidt (WA)
• David Stone (NC)
• Jeffrey J. Zayach (CO)

30
Assessment Process

• Process to include
• Readiness Review
• Application Form
• Self-assessment
• Site Visit
• Findings and Recommendations Report
• Final Determination
• Appeals Process
• Maintenance of Performance
• Re-accreditation

31
Assessment Process Principles

• The assessment process should reduce anxiety and
  increase comfort for the applicant
• PHAB will offer training, technical assistance,
  and informational materials on the accreditation
  process
• All applicants will be required to participate in
  PHAB training on the application process

31
32
Research and Evaluation Committee

• Develop a plan for evaluating the assessment
  processes and identifying research that would
  improve the standards-setting and accreditation
  program.
• Review standards and measures for validity and
  reliability.
• Provide consultation on data collection and
  interface with accreditation tracking and
  application online system.

33
Research and Evaluation Committee

• William Riley (MN) Chair
• Christine Bean (NH)
• Mary Davis (NC)
• Seth Foldy (WI)
• Les Beitsch (FL)

• Paul Erwin (TN)
• Kerry Gateley (VA)
• Brenda Joly (ME)
• Laura Landrum (IL)
• Glen Mays (AR)

34
Financing

• Workgroup on fees and incentives
• Affordability of fees critical to success
• Accreditation process should be designed with
  cost controls in mind

35
Benefits of Accreditation
Accountability credibility
Highlights HD strengths
Greater collaboration
Accreditation
Team building
Recognition validation
Better understanding of public health
36
Incentives

• Uniformly positive
• Participate in learning community
• Informed by UNC research
• Possible tangible incentives
• Improved access to funding
• Grants application requirements
• Grants reporting requirements

37
Incentives Research

• What matters to State HDs?
• Financial incentives
• Accredited agencies 60
• Agencies applying for accreditation 32
• Infrastructure/quality improvement 36
• Grants application and administration 20

38
Incentives Research

• What matters to Local HDs?
• Financial incentives
• Agencies considering accreditation 51
• Accredited agencies 37
• Infrastructure/quality improvement 33
• Technical assistance and training 27

39
Incentives Underway
40
Areas for Further Exploration

• Incentives thresholds
• Incentives from States to Locals
• Providing incentives
• Menu
• Sequencing
• Incentives for Tribal Health Departments

41
Now, To The Standards
42
Draft Standards Framework

• 11 Domains
• 31 Standards
• gt100 Measures
• Documentation

43
Eleven Domains

• Part A
• Administrative Capacity and Governance
• Part B
• Conduct assessment activities focused on
  population health status and health issues facing
  the community
• Investigate health problems and environmental
  public health hazards to protect the community
• Inform and educate about public health issues and
  functions
• Engage with the community to identify and solve
  health problems

44
Eleven Domains (cont.)

1. Develop public health policies and plans
2. Enforce public health laws and regulations
3. Promote strategies to improve access to
   healthcare services
4. Maintain a competent public health workforce
5. Evaluate and continuously improve processes,
   programs, and interventions
6. Contribute to and apply the evidence base of
   public health

45
Domain 1 Conduct assessment activities focused
on population health status and health issues
facing the community
Standard 1.1 B Collect and Maintain Population Health Data Collect and maintain reliable, comparable, and valid data that provide information on conditions of public health importance and on the health status of the population. Collect and maintain reliable, comparable, and valid data that provide information on conditions of public health importance and on the health status of the population. Collect and maintain reliable, comparable, and valid data that provide information on conditions of public health importance and on the health status of the population.
Measure Documentation and Scoring Guidance Type of Measure Type of Review
1.1.1 B Assure a surveillance system is in place for receiving reports 24/7 and for identifying health problems, threats, and hazards Documentation should address Processes and protocols to maintain the comprehensive collection, review, and analysis of data from multiple sources, Processes and protocols to assure data are maintained in a secure and confidential manner Current 24/7contact information, in the form of a designated telephone line or a designated contact person (which may be provided in rural areas via regional or state agreements) Reports of testing 24/7 contact systems, such as, internet, fax, page phone line, etc. Capacity Health Department Level
1.1.2 B Communicate with surveillance sites on at least an annual basis. Documentation should address List of providers and public health partners who may be surveillance sites Process Health Department Level
46
As you review the standards

• Consider the following questions
• Will this standard improve public health
  department performance?
• Are the important components of this standard
  captured in its associated measures for the
  standard?
• Can this standard be documented?
• Can health departments meet this standard now?

47
Standards for Discussion

• Which standards do you think are particularly
  strong?
• You would recommend that PHAB keep these
  standards.
• Which standards do you think are Problematic?
• You think PHAB should modify or possibly delete
  these standards.

48
Opportunities to Provide Feedback

• There are multiple ways to offer feedback on
  the standards and measures before April 30, 2009
• Complete the online survey at www.phaboard.org
• Complete and submit the online or hard copy
  vetting forms
• Invite PHAB to lead a standards vetting
  discussion at your group meeting
• Lead a vetting session with your group

49
Your Feedback on the Standards

• Why did this standard catch your attention?
• If you think the standard is strong, why did you
  like it?
• If you think the standard is problematic, why?
  How would you modify it?

50
For more information

• www.phaboard.org
• Contact Kaye Bender
• or any Board Member
• 703.778.4549

51
For more information..
www.phaboard.org vetting_at_phaboard.org
Contact Kaye Bender or any Board
Member 703.778.4549